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Hartshill Medical Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 27 December 2017

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. We previously inspected this practice on 24 November 2014 and rated it Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive at Hartshill Medical Centre on 28 November 2017 as part of our inspection programme.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. However, a risk assessment to reflect guidance from The Control of Substances Hazardous to Health Regulations 2002 (COSHH) in relation to the storage or spillage of mercury had not been completed.

  • The practice had clear systems to keep patients safe and safeguarded from the risk of abuse.

  • The practice had developed effective ways of reducing patient A&E attendance. All patients that attended A&E were reviewed at a weekly clinical meeting.

  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.

  • Staff involved and treated patients with compassion, kindness, dignity and respect.

  • The practice had signed up to the local authority’s safer places scheme to work as part of a network of organisations to provide assistance and support to vulnerable people over 14 years if they felt anxious or scared whilst out in the community.

  • The practice had responded to the issues patients experienced when trying to access appointments by recruiting an additional GP partner and planned to purchase a new telephone system.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation. Two of the GP partners were educational tutors at the local university. We saw that the knowledge and experiences they gained from these roles were embedded in the practice’s culture of continuous improvement.

There was one area of outstanding practice:

  • The practice provided two hours a week of dedicated appointments for the A&E department to redirect patients to the practice if they attended A&E inappropriately. Data for 2015/16 and 2016/17 showed a fall from 14.7% to 11.9% of inappropriate A&E attendances for patients registered with the practice.

The areas where the provider should make improvements are:

  • Update their recruitment policy to include reference to accounting for gaps in employment history and checking that professional registrations for clinical staff are in date.

  • Complete a risk assessment to reflect guidance from The Control of Substances Hazardous to Health Regulations 2002 (COSHH) in relation to the storage or spillage of mercury.

  • Continue to seek out ways to improve the identification of carers registered with the practice.

  • Review the Care Quality Commission (Registration) Regulations 2009 to support their understanding of incidents that are notifiable to the Care Quality Commission.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 27 December 2017

Effective

Good

Updated 27 December 2017

Caring

Good

Updated 27 December 2017

Responsive

Good

Updated 27 December 2017

Well-led

Good

Updated 27 December 2017

Checks on specific services

People with long term conditions

Good

Updated 22 January 2015

The practice is rated as good for the care of people with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 22 January 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

Older people

Good

Updated 22 January 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Working age people (including those recently retired and students)

Good

Updated 22 January 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 22 January 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). One-hundred per cent of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND and Healthy Minds. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have experienced poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 22 January 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including patients near the end of their life and those with a learning disability. It had carried out annual health checks for people with a learning disability and provided support and care to carers of vulnerable people through health reviews and providing ‘flu vaccinations. It offered longer appointments for people with a learning disability.